Dimensions within 24 weight history indices and their association with inpatient treatment outcome in adults with anorexia nervosa: analysis of routine data

Johannes Baltasar HesslerEmail author View ORCID ID profile,
Sandra Schlegl,
Martin Greetfeld and
Ulrich Voderholzer

Journal of Eating Disorders20197:19

https://doi.org/10.1186/s40337-019-0249-z

Received: 15 December 2018
Accepted: 12 May 2019
Published: 10 June 2019

Abstract

Objective

Next to weight suppression (WS), there are a range of less often examined weight history indices, and improvements to the WS construct have been proposed. We aimed to examine redundancy and overlap between 24 weight history indices in order to identify suitable constructs for further investigation.

Method

Analysis of routine data of 770 female adult inpatients treated for AN. Twenty-four indices based on highest, lowest, and current weight, as well as developmental aspects were calculated and employed in correlational and factor analyses. The indices’ ability to predict core outcomes of inpatient treatment was investigated with regression analyses.

Results

Five factors emerged: “WS and highest weight”, “weight elevation (i.e., difference between current and lowest weight since puberty)”, “lowest weight”, “age at past highest or lowest weight”, and “years since past highest or lowest weight”. The constructs within these factors showed high correlations. Most indices related to change in weight, ED psychopathology, as well as behavioral aspect of AN. While measures of WE related more to weight gain and general ED Psychopathology, indices including lowest weight were stronger predictors of changes in slimness ideal and inappropriate compensatory behaviors.

Conclusion

Many proposed weight history indices are closely related and the amount of additional information in complex indices appears questionable. While highest weight seems to dominate indices of WS, WE may rely on current weight. These findings highlight that different aspects of weight history may relate to different aspects of current ED symptoms and their amenability to change under specialized treatment.